The Ilizarov Ring External Fixator in Complex Open Fractures of the Tibia

Abstract

Introduction: Complex open fracture of the tibia particularly with bone defect and infection is one of the major problems in orthopedic surgery. There are many available alternatives in the management of these fractures. Aim: The purpose of this study is to evaluate the results and efficacy of the Ilizarov ring external fixator in treating complex open fractures of the tibia. Materials and Methods: We treated 25 patients with complex open fracture of the tibia using the Ilizarov ring external fixator between March 1999 and February 2002.The open fractures were type IIIA, type IIIB , and type IIIC in 19, 9, and 4 patients, respectively. There were 11 patients with bone loss ranging from 3 to 9 cm (average bone loss 5 cm), and 10 patients with infection. There were 11 one-level tibial transports, 5 bone graftings at the docking site, 6 internal fixations with bone grafting because of pin tract infection. Results: Results were divided into bone and functional categories [according to the association for the study and application of the method of Ilizarov (ASAMI) classification]. The bony results were excellent in 18 patients (56.2%), good in 4 (12.5%), fair in 3 (9.4%), and poor in 7 (21.9 %). The functional results were excellent in 7 (21.9%) patients, good in 14 (43.7%), fair in 4 (12.5%), and poor in 7 (21.9%). Conclusion: The Ilizarov ring external fixator is an effective a salvage procedure in the treatment of complex open fractures of the tibia as it allows for the simultaneous treatment of bone loss, infection, non-union, and deformity.

Hybrid External Fixation for Open Severe Comminuted Fractures of the Distal Femur

“…This study also showed that the hybrid external fixator has the ability of successful managing of the fracture, soft-tissue defect, infection, and bone loss simultaneously [19,20].…”

“…Although the classical Ilizarov method (ring external fixator) is an acceptable method for healing of docking site by continuous and gradual compression, as many other surgeons, we found that autogenous bone graft accelerates healing [19,21,22].…”

“…We treated most fractures in this series by ligamentotaxis and closed reduction, as in Ilizarov's original description [23] but in cases with failure to obtain anatomical reduction by ligament taxis, limited open reduction and minimal internal fixation was performed before the application of the frame in severely comminuted fractures which extend into the joint [11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Ao External Fixator; A Treatment Option for Open Tibial Diaphyseal Fractures (Type Ii, Iiia)

“…6 Freshly, outer fixators like AO external fixator are utilized broadly as a part of creating nations however the rates of malunion and contamination are moderately high. 3,7 AO fixator is extremely prominent in treating sort 111A and B open fractures of the tibia in our set up due to it is effortlessly accessible ,practical, light weight, easy to apply, slightest awkward, giving insignificant agent injury, and great access to the soft tissue and monstrous contamination. It is especially helpful in sort 111A open breaks of tibia.…”

Evaluation of Ilizarov technique in the treatment of open fractures of tibia

“…5 Recently, external fixators like Ilizarov or AO external fixator are used extensively in developing countries but the rates of mal-union and infection are relatively high. 6 With AO external fixator, the efficacy of treatment in two studies were reported to be 20-31%. 7 Open fractures are classified into three major categories, depending on the mechanism of injury, soft tissue damage, and degree of skeletal involvement.…”